Duke University Department of Anesthesiology, Duke University Health System, 4314 Orange Zone, Durham, NC, 27710, USA.
Michigan State University, Lansing, MI, USA.
Curr Pain Headache Rep. 2022 Aug;26(8):617-622. doi: 10.1007/s11916-022-01067-1. Epub 2022 Jun 25.
PURPOSE OF REVIEW: Chronic pain in the USA has presented with higher prevalence rates among women, older adults, those unemployed, living in poverty, living in rural environments, and adults with public health insurance. The COVID-19 pandemic has heavily played into the biopsychosocial model of pain. Consequently, greater impacts have affected patients with mood disorders, opioid abuse, and chronic pain. Concurrently, telemedicine has become a popular vehicle during the COVID-19 pandemic in continuing to provide quality patient care. The purpose of this article is to review the benefits and challenges related to the delivery of telemedicine for patients with chronic pain. RECENT FINDINGS: The benefits of telemedicine have been examined from patient psychosocial and convenience factors as well in relation to medical practice efficiency. Within chronic pain management, one of telemedicine's most effective utilization is seen via post-injection follow-up and assessment of further necessary interventions. Challenges also exist in this framework, from lack of physical examination and convenient close therapeutic monitoring and drug screening, to technological and resource cost capabilities of older and disadvantaged chronic pain patients, to barriers in establishing patient-provider rapport. During the COVID-19 pandemic, telehealth services were covered at rates comparable to in-person visits. Health insurance coverage and payment were major barriers for implementation of telemedicine prior to the pandemic. It is difficult to predict ongoing coverage and payment of telehealth services, although the benefits in terms of access and patient satisfaction have clearly been demonstrated. While telemedicine has proven to be a very useful tool with a wealth of advantages, the delivery of virtual healthcare for chronic pain poses a set of challenges that will need to be met to ensure the quality and standard of care continue to be upheld.
目的综述: 美国慢性疼痛的发病率在女性、老年人、失业者、贫困人口、农村居民和有公共医疗保险的成年人中较高。COVID-19 大流行对疼痛的生物-心理-社会模型产生了重大影响。因此,情绪障碍、阿片类药物滥用和慢性疼痛患者受到的影响更大。同时,远程医疗已成为 COVID-19 大流行期间提供优质患者护理的一种流行手段。本文旨在综述远程医疗为慢性疼痛患者提供服务的益处和挑战。
最新发现: 从患者心理社会和便利因素以及医疗实践效率方面,已经对远程医疗的益处进行了研究。在慢性疼痛管理中,远程医疗最有效的应用之一是在注射后进行随访和评估进一步必要的干预措施。在这一框架内也存在挑战,包括缺乏体格检查和方便的密切治疗监测和药物筛选、年老和处于不利地位的慢性疼痛患者的技术和资源成本能力,以及在建立医患融洽关系方面的障碍。在 COVID-19 大流行期间,远程医疗服务的覆盖范围与面对面就诊相当。在大流行之前,健康保险的覆盖范围和支付是实施远程医疗的主要障碍。虽然远程医疗在提供便利和提高患者满意度方面的优势已经得到了充分证明,但很难预测远程医疗服务的持续覆盖范围和支付情况。尽管远程医疗已被证明是一种非常有用的工具,具有丰富的优势,但为慢性疼痛提供虚拟医疗服务带来了一系列挑战,需要加以解决,以确保护理质量和标准继续得到维持。
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